From the Guidelines
Iron sucrose should be administered as a slow intravenous infusion at a maximum individual dose of 200 mg, without the need for a test dose, to treat iron deficiency anemia. This dosing regimen is based on the most recent and highest quality study available, which was published in the American Journal of Hematology in 2017 1. The study highlights the importance of iron sucrose in managing anemia in patients with congestive heart failure, and its approval for use in patients with chronic kidney disease (CKD) and iron deficiency anemia (IDA).
Key considerations for iron sucrose administration include:
- Maximum individual dose: 200 mg
- Administration route: slow intravenous infusion
- Test dose: not required
- Monitoring: patients should be monitored for hypersensitivity reactions during and after administration, particularly with the first dose
It is essential to calculate the total dose based on the patient's weight and hemoglobin level, which often ranges from 1000-2000 mg, and to administer each infusion over at least 15-30 minutes 1. Maintenance therapy may involve 200 mg every 2-4 weeks, and patients should be monitored periodically to assess response to treatment. Iron sucrose has a better safety profile compared to older IV iron preparations, with a lower risk of anaphylaxis, making it a suitable option for patients who cannot tolerate oral iron or require rapid correction of iron deficiency 1.
From the Research
Iron Sucrose Dosing Regimen
The appropriate dosing regimen for iron sucrose in treating iron deficiency anemia can vary depending on the patient's condition and response to treatment.
- A study published in 2005 2 used a single dose of iron sucrose of 7 mg iron/kg body weight, followed by five 200 mg infusions for the following 5 weeks.
- Another study published in 2011 3 used a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient.
- A 2019 study 4 compared iron isomaltoside 1000 with iron sucrose, which was administered as 200 mg intravenous injections, up to five times.
Efficacy and Safety
The efficacy and safety of iron sucrose have been evaluated in several studies:
- A 2011 study 3 found that intravenous iron sucrose was effective in treating adults with iron deficiency anemia, with a significant increase in hemoglobin and serum ferritin levels.
- A 2015 study 5 suggested that a total cumulative dose of 1000 mg of IV iron may be insufficient for iron repletion in a majority of patients with IDA, and a dose of 1500 mg is closer to the actual iron deficit in these patients.
- A 2020 review 6 summarized the evidence accumulated during 70 years of clinical experience with iron sucrose, highlighting its efficacy, safety, and cost-effectiveness in treating iron deficiency anemia.
Dosing Considerations
When considering the dosing regimen for iron sucrose, the following factors should be taken into account: